What Therapists have to do

I had an interesting conversation with my T yesterday and I thought it might interest people here.

T was talking to me about being triggered. He said when I first came to him, I was being triggered 90% of the time by things and only able to work through things without being triggered about 10% of the time. He said it then moved to about 75/25. Now I'm about 50/50.

So, clearly my reaction to things lies on a continuum, so I need to figure out what makes the difference and learn from that.

Then he said, one of the things he had to learn in his profession was how to keep a separation between himself and his clients. He was very quick to say that doesn't at all mean he doesn't care; he cares deeply about me for instance. But he has learned that his clients' stuff is their stuff. It isn't about him. He can't take on the pain and depression and memories because (a) that's not really possible anyway, and (b) he would have completely burned out years ago and would be no use to any client.

His point was that I do have the ability to choose how I respond to things just as he has to each and every day. He realizes I don't think I do at times, but that I have proven over time that I am learning how to do that, so further gain IS possible, even if it doesn't feel that way. A message of hope and support I guess. I'm full of skepticism, but logically I know he's right (I hate it when he's right).

Anyway, I thought his description of what therapists have to do to maintain their sanity and effectiveness was interesting.

It is the patient who has the disease. It is the client who will go to jail. The professional does the best they can with what there is to work with. Seems a reasonable stance.

Hi Chris, thanks for sharing this. I can understand what your T is saying. I can get very caught up in my head, to the extent it starts spinning, but slowly I am learning to be able to separate from it.

Now sometimes when I see other people caught in their thoughts, I can identify with them and feel for them, but still myself be able to be still in my body - so maybe this is something like your T describes?

Sounds like you have made good progress with your T - I like it when T gives me feedback about then and now.

Soup

Thank you for sharing!

This is something they tell us in group as well as sometimes things from others can trigger stuff. Unfortunately they don't tell us how to do that.
To me it is really difficult. I either have to build walls around me and don't let anybody in much to keep things away from me. Or I am open to others allowing people in.
The first one is safer but also very lonely at times. While the second is riskier, but it sure feels nice to share with others and have friendships.
I wish I would know how not to go into these extremes. But it gives me a lot of hope to hear that this has improved for you and that change is possible.

Thanks for sharing that.. What that is a great insight! A great way to look at things in my situation as well.

Definitely. Sometimes we just can't see it in ourselves. It did me good to hear him quantify my progress. You wouldn't think such things are quantifiable, but T actually talks a lot in terms of numbers/rankings/percentages now that I think about it. Must be the old clinician in him coming out.

90% down to 50%, great work!! I got rid of my triggers.

I like getting feedback about progress too. I think it's amazing that he was able to quantify it so substantially.

It would be awful if Ts took on our pain as their own. That would mean that if I tell T that this xyz thing happened, it would be like I was doing it to him. If he maintains his separation/distance, then I don't have to feel like a perp. If that makes any sense.

Anne

Completely makes sense. He says one of the most common questions he gets asked by friends/family is how can you take listening to everyone's problems all day? He says a T who is unable to keep that separation/distinction in their mind won't be a T for long. He says he's actually gotten so good at it that when his girlfriend asks him about his day, he often has virtually no memory of it. Of course once he thinks about it for a minute, it comes back, but he is extremely efficient at compartmentalizing. He says it is really a necessity. Every hour he is working with a different client with different issues. He has to be able to separate it all out so that he can give each client his full attention.

I know from working with the MR/DD population that one has to separate oneself from the issues of the clientele you work with or you would go insane. You can only really carry your own burdens; no one else's. You can sympathize, empathize, assist, etc., but you cannot take on the burden of pain that another carries. I understand completely what your T is saying. It doesn't mean he cares any less. He has to take care of himself to be able to take care of others.

His second point corresponds to my thread on choices. We choose how we respond to each and every thing in our lives; consciously or unconsciously. The process of change can be slow, but you will keep growing as long as you choose to.